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Modifying Units

  1. Default Modifying Units
    Medical Coding Books
    Can someone tell me if any of the payers (except Medciare) will take the additional units for P3-P5? I am studying for the CANPC exam and am new to anesthesia coding. We have never added the additional units for, but I read in the study guide that these can be added for commercial payers.

  2. #2
    Default
    Many Commercial Insurances do pay for P3-P5, between 1-3 additional units. You will need to check you payor policy guidelines to determine which do/don't and their reimbursement method.

  3. Default calculating units
    Thanks.
    I have another question regarding units that I hope someone can answer. The example I have is code 00918 has a base unit of 5, and the time I am entering calculates to 2 units. As I am posting this I noticed our system gives this a total of 2 units. Am I to add the 5 units to this?

  4. Default
    The total amount of units is 7 plus any modifiers. The base units total 5 plus time units equal to 2. Remember one time unit for every 15 minutes. I'm not sure what your system is giving you.

  5. #5
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    Virginia Beach Local Chapter
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    997
    Default
    Quote Originally Posted by sbottoms View Post
    Thanks.
    I have another question regarding units that I hope someone can answer. The example I have is code 00918 has a base unit of 5, and the time I am entering calculates to 2 units. As I am posting this I noticed our system gives this a total of 2 units. Am I to add the 5 units to this?
    Most programs for anesthesia add the base for you and only the minutes show when you are posting it. M ost carriers add the base as well. For example in Virginia Medicare want only the minutes of anesthesia time put in the unit block and they add the base units base on the anesthesia code on claim. Hope this helps. Remember some carriers have their own base and some do not go by the ASA relative value guide.
    Judy Wilson, CPC,COC,CPCO,CPPM,CPB,CPC-P,CPC-I,CANPC,AAPC FELLOW,CMRS

    Past AAPC-CA BOD 2010 - 2013 & 2015 - 2017


    judy@anes.hrcoxmail.com

    Nothing is impossible, the word itself says ‘I’m possible’!
    -Audrey Hepburn

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